►
From YouTube: Administrative Regulation Review Subcommittee (3-7-23)
Description
No description was provided for this meeting.
If this is YOUR meeting, an easy way to fix this is to add a description to your video, wherever mtngs.io found it (probably YouTube).
A
A
E
E
No
I
think
we
were
asked
just
provide,
update
and
I.
Don't
know
that
we
have
any
additional
update
other
than
since
the
last
hours
we've
been
working
in
good
faith
with
kma
to
address
the
concerns
with
the
ordinary
regulation,
which
the
ordinary
regulation
would
replace.
The
e-reg
gotcha.
A
I'm
going
to
take
a
brief
pause
with
you
guys,
we
got
a
couple
speakers
here.
We
have
Ben
Mudd.
G
Sure,
good
morning
my
name
is
Ben
Mudd
executive
director
of
the
Kentucky
pharmacists
Association
here
this
morning,
really
to
to
speak
in
favor
of
board
authorized
protocols.
I
know
that
there
was
some
conversation
in
the
last
R's
meeting
on
the
ordinary
regulation
and
it
sounds
like
the
board.
Pharmacy
has
worked
with
kma
to
to
address
that
regulation.
G
We've
also
met
with
kma
and
are
supportive
of
putting
the
list
of
authorized
conditions
back
into
the
regulation,
but
again
just
wanted
to
briefly
show
our
support
for
board
authorized
protocols
and
their
effectiveness
to
help
Kentucky
patients.
G
G
Pharmacists
go
through
extensive
education,
as
many
of
you
may
know,
every
pharmacist
that
that
practices
in
the
state
has
a
doctorate
level
degree
we
go
to
school
for
seven
to
eight
years
in
order
to
provide
care
to
our
patients.
In
that
training
we
get
we
we
are.
We
receive
education
on
how
to
assess
patients.
We
also
receive
extensive
education
on
when
is
an
appropriate
time
to
refer
patients
to
to
seek
care
from
from
a
primary
care.
G
So
if
you,
if
you
take,
you
know
a
moment
to
look
at
each
of
the
protocols
that
have
been
approved
thus
far,
each
of
them
include
exclusion
and
inclusion
criteria,
so
that
that
tells
a
pharmacist
here
are
the
appropriate
patients
that
that
you
should
be
providing
care
for,
and
here
are
the
exclusion
criteria.
G
The
these
are
the
the
list
of
things
that
if
a
patient
should
should
not
receive
this
type
of
care
and
and
the
protocol,
they
all
go
on
to
say
that
if
the
patient
meets
that
exclusion
criteria,
that
we
must
refer
them
to
primary
care,
if
they
don't
have
primary
care,
if
they
don't
have
a
primary
care
physician,
which
a
lot
of
these
patients
that
are
using
this
don't
have
that
we
would
have
to
refer
them
to
to
ER
if
it's
an
emergency
situation
or
Urgent
Care.
G
So
far
today,
there
have
been
no
complaints
of
of
safety
issues
or
harm
to
patients.
From
these
protocols
and
last
I'll
say
that
these
Protocols
are
collaborative
in
nature.
They
they
every
one
of
them,
requires
a
signature
from
a
prescriber
that
is
licensed
in
Kentucky
and
that
could
be
either
a
nurse
practitioner
or
or
a
physician.
So
by
that
these
protocols
would
not
be
in
use
if
there
weren't
prescribers
out
there
that
are
working
with
pharmacies
to
allow
pharmacists
to
provide
protocol
driven
care.
G
The
last
thing
I'll
say
is:
you
know
we
as
a
profession
want
to
continue
to
collaborate
with
all
parties
on
this,
and
and
we
will
continue
to
work
but
I
appreciate
you
all
taking
the
time
to
just
listen,
and
hopefully
this
has
helped
provide
some
oversight
or
some
overview
of
what
these
protocols
can
do
to
help
your
constituents
and
and
our
patients.
H
Thank
you,
Mr
chairman,
for
the
record.
My
name
is
Corey
Meadows
and
I'm,
director
of
advocacy
for
the
Kentucky
Medical
Association
and
I
appreciate
the
opportunity
to
speak
to
you
because
I
know.
Last
month
we
were
here.
We
had
significant
concerns
about
the
emergency
regulation
as
well
as
the
ordinary
regulations.
So
we
do
want
to
provide
you.
An
update.
I
can
confirm
that,
since
our
last
meeting
the
Board
of
Pharmacy
has
reached
out
to
us
to
talk
about
changes
to
the
ordinary
reg.
H
We
have
reviewed
those
changes
and
I
will
can
confirm
that
it
has
started
to
address
our
concerns
with
the
ordinary
regulation.
As
a
reminder,
we
had
issues
with
things
like
Education
and
Training
being
removed
from
the
regulation.
We
had
issues
significant
issues
with
removing
the
list
of
conditions
from
from
from
the
protocols
and
from
the
regulation
so
that
we
would
not
have
any
idea
of
what
protocols
they
were
even
developing
and
so
I
think
that
the
Board
of
Pharmacy
has
attempted
to
address
that.
What
I
will
say.
H
I,
however,
is
that
I
think
we
have
lingering
concerns
going
forward
about
process
and
about
substance.
Let's
take
the
process
first,
if
these
protocols
remained
are
allowed
to
be
done
via
regulation,
our
concern
is
is
after
the
board
changes
and
after
this
committee
changes,
there's
nothing
that
would
prohibit
a
future
Board
of
Pharmacy
from
removing
the
list
of
conditions
again
or
removing
the
Education
and
Training,
and
because
of
that,
we
think
that
there
should
be
better
process.
H
If
these
Protocols
are
going
to
exist,
substantively
yeah,
there
are
things
being
done
via
protocols
that
we
do
have
issues
with
that.
We
don't
think
is
necessarily
appropriate
at
the
pharmacy
counter,
and
so
what
we
are
proposing,
because,
as
a
reminder,
even
though
the
ordinary
regulation
is
being
proposed
to
be
changed
substantially
back
the
way,
it
was
there's
an
emergency
red
currently
in
existence
where
there
is
no
holistic
conditions
and
No
Education
and
Training
and
I
think
that
is.
That
is
an
issue
and
I
think
that's
an
example
of
why
this
is
a
process
problem.
H
So
what
we
are
proposing
and
we've
reached
out
to
the
Board
of
Pharmacy
and
I
think
Mr
Harlow
has
has
given
us
a
pretty
firm
commitment
to
sit
down
with
us
and
we've
also
asked
the
pharmacists
Association.
We
had
a
good
meeting
last
week
waiting
to
hear
back
from
them
on
whether
they
would
agree
to
do
this,
but
we
want
to
sit
down
as
soon
as
possible,
but
but
it
may
carry
over
into
the
interim
as
well
about
how
we
how
we
deal
with
this
process
protocol
process
going
forward.
H
We
can
avoid
the
problem
that
we've
experienced
over
the
last
several
months.
We
can
avoid
that
in
the
future.
So
I
hope
that
update
is
helpful
to
you
happy
to
answer
any
questions,
and
you
certainly
have
our
commitment
to
continue
working
with
the
Board
of
Pharmacy,
as
well
as
the
Farmers
Association,
to
get
a
better
process
in
place.
Thank
you.
E
Yes,
that
is
correct,
so
pharmacists
under
the
under
under
the
federal
prep
act,
pharmac
pharmacists
can
prescribe
paxilvid,
and
so
we
we
were
contacted
by
Department
of
Medicaid
services,
because
pharmacists
are
not
able
to
Bill
if
they
prescribe.
E
So
they
asked
if
we
could
have
a
board
authorized
protocol
in
place
in
order
to
to
have
some
sort
of
DMS
Statewide
protocol,
that
pharmacists
could
use
for
the
purpose
of
being
able
to
bill
for
that
service
and
Medicaid
recipients
being
able
to
receive
Pax
loaded
by
Pharmacy
providers.
And
so
we
were.
We
were
contacted
after
the
amendment
of
the
ordinary
regulation,
which
is
why
we
had
to
put
forward
the
emergency
regulation
under
the
amended
version.
E
A
Good
any
other
questions
for
members.
I've
got
a
couple.
This
question
is
for
Mr
Meadows.
So
could
you
be
precise
on
what
you're
looking
for
it
appears?
You
know
the
kma
is
looking
for
something
that
that's
not
not
here.
It's
not
this
e-rig,
and
so
would
that
be
keeping
the
protocols
the
same,
adding
packs
loaded
to
that
list
of
protocols
and
then
keeping
the
education
requirement
is
that
kind
of
where
yeah.
H
I
think
more
immediately,
we
kind
of
describe
it.
Is
we
got
to
put
it
in
medical
terms?
We've
got
an
emergent
issue,
which
is
you
know
when
you
would
go
to
the
ER
to
be
treated
and
we
have
a
chronic
condition,
which
is
the
long-term
solution
right
and
so
more
immediately.
The
reg
that
you
have
in
front
of
you.
We
certainly
are
encouraged
that
it
has
been.
The
proposal
is
to
take
it
back
to
substantially
the
way
it
was
reinserting.
The
Education
and
Training
reinserting
the
list
of
conditions.
H
I
understand
that
there's
now
an
addition
for
plexovid,
but
but
also
it
keeps
in
place
the
registry
that
was
proposed,
as
well
as
a
protocol
committee.
That
is
certainly
substantially
in
much
better
form
than
what
the
e-reg
the
way
the
e-reg
is
operating.
Currently,
but
that's
the
more
immediate
problem-
and
our
folks
have
said
you
know
if
we've
got
to
have
the
reg.
H
That
certainly
looks
a
lot
better,
and
so
we
defer
to
the
committee
on
what
to
do
on
the
ordinary
regulation,
but
again
I
want
to
emphasize
that
there's
a
long-term
problem
as
well.
We
think
that
these
types
of
protocols
should
not
be
subject
to
regulation
and
so
and
instead
we
think
that
it
should
be
put
in
the
statute,
and
that's
there's
precedent
for
that.
This.
H
There
are
statutes
on
the
books
talking
about
doing
vaccinations
via
protocols
and
that's
fine,
because
the
general
assembly
has
signed
off
on
that,
and
so
we
think
any
protocol
should
be
done
be
put
in
the
list
of
conditions
that
are
subject
to
protocols
should
be
put
in
statute
and
that'll
take
a
legislative
change.
So
we
think
that's
the
long-term
solution.
H
In
order
to
do
that,
I
think
you
need
to
hear
from
us
and
the
Board
of
Pharmacy
and
the
pharmacist
Association,
on
which
conditions
are
appropriate
for
protocols
and
that's
why
that's
a
long-term
conversation
that
we
have
to
have
I
hope
that
helps
Mr
chairman
I
just
want
to
express
that
there's
both
a
short-term
issue
and
what
we
think
is
a
process
problem
that
needs
to
be
worked
out
through
statute
and
conversations
around
that.
A
H
H
J
H
J
And
I
guess
my
comment
would
be
let's
if
the
conversations
are
happening,
let's
let
that
play
out
between
those
parties
that
that
I
think
want
to
get
to
an
agreement
rather
than
deal
with
this
e-brag
today.
A
K
A
So
it's
very
important
that
if,
if
the
legislature
is
going
to
have
a
say
on
this
issue
that
it
has
to
be
now
this
meeting,
because
this
is
the
last
meeting
before
the
end
of
session-
and
so
rather
than
personally-
and
this
is
my
opinion-
I-
don't
want
to
see
this
hanging
out
there
while
discussions
are
going
on
and
without
you
all,
knowing
the
full
intent
of
the
legislature.
A
E
B
E
A
Thank
you
any
comment.
I'm
gonna
go
ahead.
F
A
We
could
do
11,
we
could
do
one.
A
A
So,
just
as
a
little
bit
of
guidance,
there
is
the
ordinary
rag.
That's
hanging
out
there,
you
know
and
that
that's
continuing
to
go
through
the
process,
hopefully
sounds
like
you
guys
are
on
the
path
to
come
to
to
some
sort
of
agreement,
and
so,
as
far
as
the
providers
go,
I
think
you
all
can
resolve
this
fairly
quickly
and
the
main
intent
is
to
not
take
this
outside
of
the
regulatory
process,
but
to
keep
it
in
the
regulatory
process
and
then
do
that
first
and
then,
as
Mr
Meadows
stated.
A
If,
if
we
want
to
put
this
in
the
statute
later,
that's
a
whole
a
whole.
Another
question:
we're
not
even
get
we're
not
even
there
yet,
but
that's.
The
intent
of
this
committee
is
is
that
you
know
these
remain
in
the
regulatory
process
and
not
the
pharmacy
board
doesn't
become
kind
of
a
fiefdom
to
itself
to
to
look
at
these
issues.
So
any
other
questions.
D
A
Reneau
I
am
the
Deputy
Commissioner
Kentucky
Department
of
Veterans
Affairs.
Thank
you.
There's
a
staff
Amendment.
Do
we
have
a
motion
for
approval,
the
staff
Amendment?
We
have
a
motion.
We
have
a
second
without
objection,
is
so
ordered
any
questions
from
members
of
the
committee
on
this
set
of
regs.
A
A
D
201
KR
16
550,
amends
to
add
definitions,
require
an
animal
control
agency
to
submit
a
form
to
request
a
new
designated
on-site
manager
allow
the
board
to
accept
a
local
employment
background
check,
authorize
the
board
to
conduct
closeout
inspections
of
expired
drugs,
delete
sections
of
approved
drugs
and
certain
inspection
requirements
and
update
material
Incorporated
by
reference.
201
KR,
16
552
establishes
requirements
for
drugs
and
procedures
relating
to
animal
euthanasia
at
certified.
D
Specify
euthanasia,
training
relates
to
euthanasia
by
injection
direct
course.
Providers
to
report
and
attendees
absence
of
more
than
15
minutes
allow
the
board
to
accept
local
employment
background
check
results
and
update
material
Incorporated
by
reference.
201
KR
16562
establishes
the
duties
and
responsibilities
of
an
animal
euthanasia,
specialist
animals,
drugs
and
methods
approved
for
euthanasia,
the
prohibition
against
practicing
veterinary
medicine
and
a
provision
for
disciplinary
action.
201
KR
16572
amends
to
require
an
animal
control
agency
to
identify
each
Associated
animal
euthanasia
specialist.
D
Allow
the
board
to
accept
a
local
background,
check
results,
authorize
an
online
request
to
change
a
name
or
address
and
update
forms.
201
KR,
16
610
amends
to
rename
the
complaints.
Screening
committee
to
the
grievance
committee
remove
the
requirement
that
the
board
chairs
screen
every
potential
grievance
Grant
credential
holders
20
days
to
respond
to
a
written
grievance
or
to
a
notice
of
an
administrative
hearing
and
update
material
Incorporated
by
reference.
The
staff
amendments
for
20K
are
16
550,
552,
560,
562
and
572
all
make
changes
for
clarity
and
to
comply
with
care
as
chapter
13A.
A
A
N
A
Please
identify
yourself
for
the
record.
My
name
is
Steven
Curley
I'm,
the
executive
director
of
the
Kentucky
Board
of
physical
therapy.
There's
a
staff
amendment.
Is
there
a
motion
for
approval
of
the
staff
Amendment?
We
have
a
motion.
We
have
a
second
without
objection.
Is
so
ordered
any
questions
from
members.
D
21K
or
23051
establishes
a
definition
of
licensee
the
requirements
for
a
renewable
termination
and
reinstatement
of
a
license
and
the
application
for
renewal
form.
The
admitted
after
comments
version
includes
methods
for
applying
for
Renewal
reinstatement
and
how
terminations
are
handled.
Clarifies
definitions
separates
each
section
and
provides
a
better
description.
Reorder
sections
clarifies
items,
allows
for
new
sections
within
the
regulation
and
provides
clarification
with
a
new
title
and
additional
information
related
to
the
title
of
that
section
and
updates
material
Incorporated
by
reference.
The
staff
Amendment
amidst
various
sections
to
comply
with
Keras
chapter
13A.
A
B
D
202
kr7201,
301
and
330.
all
are
men
to
conform
to
requirements
of
the
ER
EMT
relating
to
the
minimum
age
requirement
and
certain
educational
requirements
delete
the
pre-enrollment
background
check
and
clarify
that
only
the
nremt
continuing
competency,
competency
program
for
continuing
education
is
required
for
certification,
renewal
and
reinstatement.
The
staff
amendments
all
make
changes
to
comply
with
Kara's
chapter
13A.
M
7401
is
being
amended
to
bring
the
requirements
for
paramedic
licensure
into
Conformity,
with
the
requirements
of
the
National
Registry
of
emergency
medical
technicians.
Remove
the
requirement
of
pre-enrollment
background
check,
clarify
that
only
the
national
component
of
the
continued
competency
program
for
paramedic
continuing
education
is
required
for
licensure
renewal
and
reinstatement
and
remove
the
requirement
that
proof
of
current
in
our
EMT
certification
and
proof
of
certain
training
be
provided
when
a
paramedic
downgrades
his
or
her
license.
M
755
establishes
a
minimum
response
time
for
non-emergency
calls
and
permits
assistance
from
other
agencies
when
the
minimum
response
time
cannot
be
met.
7601
is
being
amended
to
clarify
mstei
requirements,
reduce
EMS,
Tei,
pass
rate
requirements
to
help
avoid
disciplinary
actions,
align
cycle,
motor
skill
testing
requirements
with
the
requirements
of
the
National
Registry.
Allow
assistant
instructors
to
teach
up
to
40
percent
of
courses
to
mitigate
the
shortage
of
EMS
Educators,
remove
minimum
patient
contact
requirements
to
allow
EMS
Educators
to
determine
student
competency
on
an
individual
basis
and
avoid
delays
in
student
certification
or
licensure.
M
Allow
100
of
courses
to
be
conducted
online
as
permitted
by
the
National
Registry.
Remove
the
student
teaching
requirements,
remove
unnecessary
or
redundant
documentation
requirements
and
allow
the
board
to
recognize
and
approve
equivalent
educator,
certifications
from
other
U.S
states
and
territories.
A
B
M
The
245
establishes
the
requirements
for
the
recovery
and
removal
of
certain
portions
of
big
game
animals
and
Upland
game
birds
and
establishes
the
rules
for
carcass
disposal.
3120
is
being
amended
to
improve
training
requirements
for
nuisance,
Wildlife,
Control
operators,
limit
movement
of
rabies,
Vector
species
require
dispatch
of
exotic
species
and
clarify
the
legal
use
of
poison
on
Wildlife.
The
staff
suggests
amendments
to
these
regulations
amends
various
sections
to
comply
with
the
Drafting
and
formatting
requirements
of
KRS
chapter
13A
and
make
technical
changes.
A
K
This
regulation
amends
to
update
the
policies
and
procedures
of
Kentucky
State
Penitentiary,
including
policies
on
missing
or
stolen
inmate
property,
restrictive
housing
unit,
special
security
unit,
health
care
and
inmate,
visiting
and
correspondence.
The
staff
suggested
amendments,
various
sections
and
the
material
Incorporated
by
reference
to
align
Provisions
with
other
departmental
policies
and
to
comply
with
13A
drafting
requirements.
A
A
B
M
701-8010
establishes
the
public
charter
school
student
application,
Lottery
enrollment
process.
701
8020
establishes
the
requirements
for
the
competence
report,
performance
and
evaluation
for
Charter
School
authorizers
701
8030
establishes
requirements
for
the
appeals
process.
701
8040
establishes
requirements
for
conversion,
public
charter
schools,
701-8050
establishes
the
requirements
for
the
calculation
and
distribution
of
funds
to
a
public
charter
school,
the
schedule
of
the
distribution
of
funds
and
the
fines
for
failure
to
timely
transfer
funds.
M
The
staff
suggested
amendments
to
these
regulations
amends
various
sections
to
comply
with
the
drafting
requirements
of
KRS
chapter
13A,
correct
statutory
citations
and
make
technical
changes.
7043
303
is
being
amended
to
update
the
material
Incorporated
by
reference
to
remove
the
standards
Incorporated
by
referencing
704
KR
8
120
704-8120
establishes
the
minimum
contact
requirements
of
krs-158-6453
to
be
be
met
by
student
pursuance
to
Kentucky
academic
standards
for
science.
The
staff
suggested
amendment
to
704-8120
amends
the
necessity
function
and
Conformity
paragraph
for
clarity.
M
707
1002
is
being
amended
to
remove
Provisions
inconsistent
with
the
individuals
with
disability,
Education
Act
and
the
guidance
of
the
official
office
of
special
education
programs.
The
staff
suggested
Amendment
amends
the
statutory
Authority
paragraph
to
add
a
statutory
citation
and
section
1
to
comply
with
the
drafting
requirements
of
KRS
chapter
13A
and
make
technical
changes.
H
A
A
P
Correct,
yes,
the
regulations
in
the
701
title
are
in
response
to
house
bill
nine.
There
are
emergency
regulations
that
were
filed
and
are
already
in
place.
P
These
ordinary
regulations
are
identical
to
the
emergency
regulations
that
are
in
place
and
we'll
the
the
emergency
regulations
will
expire
and
these
will
take
their
place,
but
all
of
the
amendments
are
in
response
to
changes
to
the
law
made
in
house
bill.
Nine
from
the
previous
legislative
session.
A
B
M
1090
emergency
is
being
amended
to
update
requirements
in
compliance
with
KRS
341
350,
requiring
that
unemployment
claimants
report
work
search
activities
each
week
for
which
a
claim
for
benefits
has
been
made,
specify
the
type
of
activities
that
qualify
as
work
search
activities
and
require
the
unemployment
claimant
to
certify
work,
search
activities
under
the
penalty
of
perjury
as
verification.
One
100
emergency
is
being
amended
to
add
the
statutory
exception
to
the
definition
of
week
of
unemployment.
For.
L
A
N
F
A
A
B
A
You
so
much.
There
are
no
amendments
on
these
regs.
However,
we
do
have
a
speaker
Alex
if,
if
you
all
could
make,
if
y'all
could
okay
fair
enough
any
questions
from
members,
seeing
none,
please
call
the
next
regulation.
Thank
you.
Thank
you.
A
A
I
Thank
you,
commissioner.
Thank
you
all
for
being
here
today.
I've
got
a
dentist
back
home
that
reached
out
to
me
after
our
last
meeting
where
we
did
find
the
regulations
to
fish
and
and
they
had
a
question
on
rates
and
and
US
finding.
I
You
know
a
deficient,
you
know,
I
just
think
there
needs
to
be
Clarity.
There
is
nothing
prohibiting
you
all
from
negotiating
new
rates
with
mcos
and
new
fee
schedules
and
I
just
think
for
public
record.
That
needs
to
be
out
there
for
our
providers
to
understand,
and
we
know
we'd
love
to
work
with
you
and
we
want
to
help
our
providers,
but
that
just
needs
to
be
clear
in
the
Public's
mind.
Thank
you.
Q
We
did
this
regulation
here
is
related
to
the
hearing
program,
but
to
address
the
dental
comments,
we
have
been
speaking
with
our
Dental
Community.
After
the
regulations
were
filed,
we
did
increase
rates
specifically
because
we
tied
the
increased
services
for
adults.
We
tied
that
to
the
fee
schedule
in
an
effort
to
get
dentists
to
provide
those
services,
so
we
have
given
some
raises
on
certain
codes.
What
we're
doing
is
trying
to
be
very
strategic
rather
than
giving
an
across-the-board
raise.
C
Thank
you
for
bringing
this
forward.
As
you
know,
it's
very
near
and
dear
to
my
heart
so
but
I
do
have
a
couple
clarifying
questions.
Is
this
rag
just
in
regards
to
hearing
testing
for
adults,
or
is
this
also
in
order
to
provide
technology
when
appropriate.
C
Okay,
so
so
in
the
statement
of
emergency,
it
is
said
that
over
900
000
Medicaid
recipients
could
immediately
benefit
from
the
availability
of
Audiology.
Dental
and
visual
coverage.
I
agree
so,
however,
in
the
in
the
regulation
review
form
under
the
economic
impact,
it
states
that
this
should
cost
about.
Just
for
the
hearing
about
a
hundred
and
fifty
thousand
dollars
annually
is
what
was
estimated
so
I
know
the
single
unit
cost.
C
O
O
Q
O
It's
what
we'll
put
into
it
will
be
a
little
bit
different
because
the
mcos
may
expect
to
pay.
You
know
it's
it's
less
than
just
the
900
000
people
that
they
have
coverage
for
it.
It
like
Insurance
type
coverage,
though,
that
we're
we're
paying
for
so.
We
do
of
course,
expect
a
far
smaller
percentage
of
the
the
population
to
to
access
the
services.
Okay,.
C
One
last
question
other
conversations
with
Audiology
fee
scheduled
as
well,
and
could
you
give
an
update
on
that
because
I
believe
it
was
2006
the
last
time
that
it's
been
updated?
We.
Q
Have
been
having
some
conversations
with
our
technical
advisory
committee
on
those
rates
and
again,
we
believe
that
these
changes
are
just
the
very
first
step
in
amending
the
Medicaid
Program
to
bring
it
where
it
needs
to
be
as
far
as
reimbursement
and
services
for
our
members.
So
we
are
having
those
conversations
and
again
want
to
be
very
strategic
in
our
increases
or
in
our
reimbursements
for
providers,
rather
than
doing
that
across
the
board.
Raise
we're.
Q
A
You
couple
a
comment
and
a
question
that
first
comment
is
to
Mrs
Lee
I
just
want
to
let
you
know.
I
did
receive
your
email
and
I
appreciate
that
there
is
the
response
we
get
a
little
busy
up
here,
sometimes
and
don't
always
get
a
chance
to
respond
to
emails
quickly,
but
I
appreciate
your
response.
A
The
as
far
back
to
the
rates.
You
know
we
have
the
expansion,
we
have
the
expansion
as
one
issue
to
me.
You
know
the
rates
another
another
issue
and
I
know
you've
already
touched
on
it.
But
could
you
just
at
what
phase
are?
Is
the
right
discussion?
Is
it
in
public
comment,
I'm
assuming
there's
a
different
discussion
for
each
segment?
Is
that
is
that
kind
of
how
it's
happening.
Q
That
is
correct.
The
dental
increase,
for
example,
has
already
happened.
It
has
been
put
into
place,
the
fee
schedules
have
been
adjusted
is.
Q
A
So
I
guess
my
main
question
that
that
gets
to
my
point
this
this
red,
the
reg
we
talked
about
last
month.
You
know
we
found
it
deficient
if
we
eventually
find
that
Reg
null
and
void.
Q
A
Q
I,
don't
think
that
we
would
have
to
do
an
e-rag
for
the
rates.
I
think
that
you
know
we
we
could
amend
them
again.
This
is
contingent
upon
the
Adult
Services.
We
are
the
reason
that
we
are
going
or
or
the
reason
that
we
want
to
provide
these
Services
again.
Q
Workforce
Development
individuals
who
cannot
see
who
cannot
hear
who
don't
have
a
nice
smile
they're,
not
entering
the
workforce,
because
people
don't
want
to
interview
them
or
they
have
stigma
against
them
when
they
go
for
interviews
again,
we
know
that
oral
health
is
very
important
to
overall
health.
It
directly
links
to
heart
disease,
preterm
deliveries,
getting
those
services
to
adults
right
now
will
prevent
those
those
diseases
from
progressing
in
the
future
and
we'll
save
money.
Hearing,
for
example,
it's
has
been
known.
Q
There
have
been
studies
that
show
that
an
individual
who
gets
a
hearing
aid
prior
to
complete
hearing
loss
is
18
percent,
less
likely
to
develop
to
develop
Alzheimer's.
So
again
we
want
us.
We
want
to
invest
in
these
Services
now
for
various
reasons,
but
mainly
to
prevent
future
increased
costs
in
these
areas.
O
I,
just
the
the
policy
regs
that
we're
in.
If,
if
we,
if
they
were
found
permanently
null
and
void,
then
there
are
some
services
that
would
no
longer
exist,
and
so
those
would
also
be
coming
off.